The gait speed and handgrip strength represented the core determinants of physical frailty and sarcopenia, which were reported to be associated with cognitive impairment and decline. Different physical measures might differentially affect cognitive changes, such as higher-level cognitive change and global cognitive decline. This study examined the differential associations of gait speed and handgrip strength with 10-year cognitive changes among community-dwelling older people. Participants aged 60 years and over living in the community were invited for study. Gait speed and handgrip strength were classified into 5 groups based on quintiles at baseline. Cognitive functions were assessed using the Mini-Mental State Examination (MMSE) and Digit Symbol Substitution Test (DSST) every 2 years from baseline for a period of 10 years. Linear mixed effects models were used to determine the role of gait speed and handgrip strength in the prediction of 10-year cognitive changes by adjusting covariates, including age, gender, education, depressive symptoms, marital status, smoking status, instrumental activities of daily life (IADL), Charlson Comorbidity Index (CCI), and body mass index (BMI) at baseline. A total of 1096 participants were enrolled in the study. The mean age was 69.4 ± 5.8 years and 50.9% were male. The slowest gait speed group showed a significantly greater decline in the DSST scores over 10 years than the highest group (estimate = 0.28 and P = 0.003), but not in the MMSE scores (estimate = 0.05 and P = 0.078). The lowest handgrip strength group showed a significantly greater decline in the MMSE scores than the highest group (estimate = 0.06 and P = 0.039) and in the DSST scores than the highest two quintiles (estimate = 0.20 and P = 0.033 for the fourth quintile; estimate = 0.20 and P = 0.040 for the highest quintile) over 10-year follow-up. A slow gait speed could predict 10-year cognitive decline using DSST, and a low handgrip strength could predict 10-year cognitive decline using MMSE in addition to DSST. Thus both physical measures are lined to cognitive decline but there may be different mechanisms between brain and physical functions.

Background: Although muscle quality evaluations are currently considered important for diagnosing sarcopenia, data from the general population are lacking. This study used mid‐thigh computed tomography measurements to evaluate age‐related and sex‐related differences in quadriceps femoris muscle quality and mass and their relationships with knee extension strength (KES).Methods: Cross‐sectional data from 520 Japanese individuals (273 men and 247 women, mean age: 63.1 ± 10.6 years) were analysed. Mass and quality were assessed using quadriceps cross‐sectional areas (CSAs) and computed tomography values (CTVs), respectively. The four constituent muscles, intermuscular adipose tissue, and entire quadriceps area (total quadriceps muscles + intermuscular adipose tissue) were assessed, and the data were stratified by five age groups and sex. To evaluate age‐related decline, linear and quadratic equations were tested for fit according to the constituent muscles and sex. KES could be measured in 472 of the 520 participants (254 men and 218 women, mean age: 62.3 ± 10.3). Multiple linear regression analyses with age‐adjusted models were then used for evaluating the relationships between KES and quadriceps measurements.Results: All muscle CSAs and CTVs showed downward trends with age (men: P < 0.001 for all; women: vastus medialis CTV, P = 0.004; others, P < 0.001); the intermuscular adipose tissue CSA did not show any trend (men: P = 0.938; women: P = 0.139), although its percentage of the entire quadriceps area showed an upward trend in both sexes (P < 0.001). Men exhibited a quadratic decline in the CSAs for the entire quadriceps area (P = 0.016), total quadriceps muscles (P = 0.021), the vastus medialis (P = 0.010) and vastus lateralis (P = 0.038), and all CTVs (rectus femoris, P = 0.044; others, P < 0.001). Women exhibited a quadratic equation in the CTV for rectus femoris (P = 0.031), but a linear decline in the other variables (P < 0.001 for all). Both the total quadriceps muscles CSA and CTV were significantly associated with KES in both sexes (P < 0.001). For each muscle, the CSAs of the vastus medialis (P < 0.001) and vastus intermedius (P = 0.001) were significantly associated with KES in men, whereas the vastus medialis CSA (P < 0.001), vastus lateralis CSA (P = 0.006), rectus femoris CSA (P = 0.020), and vastus intermedius CTV (P = 0.025) were significantly associated with KES in womenConclusions: Age‐related quadriceps femoris changes in mass and quality differed by sex and the constituent muscles. The constituent muscles contributing to KES differed between men and women. Quadriceps CSA and CTV measurements are useful for objectively assessing age‐related and sex‐related muscle deterioration and KES.

Background: Components of physical frailty cluster into subtypes, but it remains unknown how these might be associated with age‐related functional declines and multimorbidities. This study aims to investigated associations of physical frailty subtypes with functional declines and multimorbidity in a 10 year longitudinal cohort survey.Methods: Complementary longitudinal cohort study used group‐based multitrajectory modelling to verify whether frailty subtypes discovered in Taiwan are presented in another aging cohort, then investigated associations of these subtypes with cognitive decline and multimorbidity. Participants aged ≥50 years were recruited from the third to sixth waves (May 2002 to July 2010) of the National Institute for Longevity Sciences‐Longitudinal Study of Aging, in Japan. People with incomplete data, pre‐frail/frail status before their index wave, and those with incomplete data or who died during follow‐up, were excluded. Group‐based trajectory analysis denoted five established physical frailty criteria as time‐varying binary variables in each wave during follow‐up. Incident frailty was classified as mobility subtype (weakness/slowness), non‐mobility subtype (weight loss/exhaustion), or low physical activity subtype. General linear modelling investigated associations of these frailty subtypes with activities of daily living, digit symbol substitution test (DSST) and Charlson Comorbidity Index (CCI) at 2 year follow‐up.Results: We identified four longitudinal trajectories of physical frailty, which corroborated the distinct subtypes we discovered previously. Among 940 eligible participants, 38.0% were robust, 18.4% had mobility subtype frailty, 20.7% non‐mobility subtype, and 20.1% low physical activity subtype. People with mobility subtype frailty were older than those with other frailty subtypes or robust status and had higher prevalence of hypertension, diabetes, and heart failure. In the multivariable‐adjusted general linear models, mobility‐subtype frailty was associated with a significantly lower DSST score (point estimate −2.28, P = 0.03) and higher CCI (point estimate 0.82, P < 0.01) than the other groups.Conclusions: Mobility‐subtype frailty was associated with functional declines and progression of multimorbidity; the long‐term effects of physical frailty subtypes deserve further investigation.

We examined associations between dietary diversity and all-cause and cause-specific mortality in 386 men and 413 women (age range, 60–79 years at baseline) who took part in the National Institute for Longevity Sciences-Longitudinal Study of Aging study from 1997 to 2000. Dietary intake was assessed using three-day dietary records and photographs. The Quantitative Index for Dietary Diversity was used to determine the dietary diversity among thirteen food groups. Dietary diversity score and each food intake were examined by sex-stratified tertiles, and hazard ratios (HR) were calculated to compare the risk for all-cause and cause-specific deaths across tertiles, after controlling for age, sex, body mass index, alcohol intake, smoking status, education, physical activity, and disease history. During a mean follow-up of 15.7 years, 289 subjects (36.2%) died. Compared to the subjects in the lowest tertile, the multivariate-adjusted HR for all-cause and cancer mortality was 0.69 (95% confidence interval (CI): 0.51–0.94) and 0.57 (95% CI: 0.33–0.98), respectively (trend p < 0.05), in subjects in the highest tertile of dietary diversity. There were no significant associations between dietary diversity score and death from cardiovascular or cerebrovascular disease. Eating a variety of foods might contribute to longevity in older Japanese community dwellers.